Epikeratophakia is a new form of refractive surgery in which a piece of donor tissue is shaped on the cryolathe and sutured to a peripheral trephined groove in the recipient cornea. It is used for the correction of monocular aphakia in adult patients unable to tolerate contact lenses and not candidates for secondary implantation of intraocular lenses; infants and children with congenital and traumatic cataracts who need clear retinal images to prevent amblyopia, patient with unilateral high myopia, and keratoconus patients. Over the past two years, we have worked on the surgical technique and general methodology, including refining the mechanics of lathing corneal tissue, controlling donor tissue hydration, improving surgical technique, documenting repopulation of the donor tissue by host cells, establishing the stability of the new anterior corneal surface, documenting the clarity of the grafted cornea, and examining the clinical recovery of the recipient eye after graft removal. In the future, we plan to compare the stability of the anterior corneal curvature and the rate of clearing of fresh, frozen, and frozen and lyophilized epikeratophakia grafts with and without mechanical dehydration in the cornea press. We will test alloplastic materials for use in conjunction with epikeratophakia grafts to provide higher dioptric powers than can be made with currently available equipment and tissue. We will also test the functional and immunologic feasibility of using xenograft material such as pig corneal tissue as epikeratophakia grafts on the monkey eye. We will examine the ultrastructural organization of the graft tissue and the host cornea, including tissue preserved and processed in various ways, tissue used in conjunction with alloplastic materials, and xenograft tissue. Finally, we will attempt to correlate reinnervation of epikeratophakia grafts on monkey eyes with corneal sensitivity measured in human patients by aesthesiometry. Surgical results will be obtained in both young and adult monkeys, as this procedure has important applicability in the prevention of amblyopia in infants and children with congenital or traumatic cataracts.